Phyllis Ramondetta Rn, Bs, Ccm, Clcp, Mscc, Clnc Email & Phone Number

Provide expert medical management oversight and supervision of catastrophic (ABI, SCI, burn, etc.) and serious injury cases. Supply medical cost containment recommendations and oversight to our clients’ catastrophically injured workers, collaborating with MEC’s Medical Director, Claim Analysts and Attorneys, external claim administrators (TPAs and others).

Chesterfield, Missouri

Hartford, Connecticut Area Tampa, Florida Area

Differentiators - Insurance Carrier Strategies - Defense and PlaintiffIn addition to the legal nurse consulting and life care planning services offered, a unique skill set positions Phyllis above the rest. Having worked with major insurance carriers, including The Hartford and Travelers, enables a clear understanding of key strategies which are employed.

Greater Boston Area

I built out the vision for Ametros' Health Navigator Program which included in-house nurse care partners that provide medical care coordination to Ametros’ members after settling their workers' comp or liability case. The focus was on creating and implementing the program, shaping a team to provide quality clinical support for injured parties and their.

Hartford, Connecticut Area

Provided medical oversight and supervision, of catastrophic (ABI, SCI, burn, etc.) and serious injury (RSD, electrical injury, chronic pain, etc.) cases with individual medical exposure from several hundred thousand to several million dollars across the country. Developed medical management strategies, and provided medical reserve analysis, life time.

Farmington, CT

Was responsible for managing both medical quality assurance and training programs including Utilization Review and Telephonic Case Management services at a national level. Managed quality assurance analysts and training staff and oversaw all audits completed by the QA staff. Evaluated trends and implemented training programs to improve overall medical.

Provided in depth analysis and audits of the medical and RTW management of claim files and provided specific recommendations through annual audits. Was accountable for multiple specialty audits: ie: SOX audits, Medical Bill Audits, TPA service audits, vendor audits, medical audits. Medical Quality Audits were completed on Work Comp, Short and Long Term.

Provided complete medical analysis of Large Loss cases with paids >500K in medical spend and generated a concise report outlining the medical chronology of the case and provided a lifetime medical cost projection to ensure proper medical reserving on catastrophic cases. Obtained certification in Life Care Planning and Medicare Set Aside allocations and.

Bachelors Degree

Mscc/Clcp, Medicare Set Aside Consultant And Certified Life Care Planner Training

2005 - MSCC designation attained after completion of the Medicare Set Aside Consultant training at University of Florida in conjunction.